Senior Analyst, Authorization Services Design & Configuration

This is a fully remote position, open to applicants in Texas.

📋 Description

• Oversee the configuration and upkeep of authorization workflows, rulesets, and automations within the UM platform.

• Convert business needs into detailed technical specifications.

• Ensure that business rules and logic are accurately reflected, tested, and executed.

• Examine and resolve escalations through root cause analysis of system behavior and configuration discrepancies.

• Identify pain points in the authorization process and document opportunities for workflow enhancement and automation.

• Act as the primary subject matter expert for the UM system.

• Educate Product, Clinical, and Regulatory teams on the impact of configuration on operations.

• Create testing protocols and execute test scenarios to verify system behavior and configuration precision.

• Lead corrective actions when system behavior strays from expected outcomes.

• Manage assigned caseloads and project tasks utilizing dashboard management and prioritization.

• Keep documentation updated regarding business rules, technical specifications, and workflow designs.

• Report directly to the Associate Director, UM Optimization.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• Minimum of 2 years of experience in system configuration, business rules management, or technical workflow design.

• At least 2 years of experience in a technical/operational position involving root-cause analysis and data troubleshooting.

• Intermediate to Advanced proficiency in Excel/Google Sheets (including vlookups, pivot tables, and data manipulation).

• Experience in assessing and understanding end-to-end process impacts within complex technical environments.

• Excellent communication skills with the capability to clarify technical system logic to non-technical stakeholders.

• A minimum of 1 year of practical knowledge within the healthcare industry (payer or provider).

• Prior work experience in Prior Authorizations or Insurance Operations.

• Over 2 years of proficiency in SQL, BigQuery, or similar database languages.

• Familiarity with project management and communication tools such as JIRA, Linear, and Slack.

• Experience handling large datasets, data verification, and data management.

🏝️ Benefits

• Employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• 401(k) plan participation.

• Life insurance.

• Disability insurance.

• Paid wellness time and reimbursements.